- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $52.48 / $114.82
| Facility | | $13.18 | $52.48 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $14.13 / $25.70
| Professional | | $10.00 | $14.13 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $10.72 / $12.30
| Professional | | $8.51 | $10.72 | $12.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $60.26 / $104.71
| Facility | | $23.44 | $60.26 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $9.77 / $16.98
| Professional | | $5.01 | $9.77 | $16.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $27.54 / $107.15
| Facility | | $16.22 | $27.54 | $107.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $17.38 / $17.78
| Facility | | $17.38 | $17.38 | $17.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $38.90 / $95.50
| Facility | | $20.42 | $38.90 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $12.88 / $29.51
| Professional | | $10.00 | $12.88 | $29.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $83.18 / $83.18 / $100.00
| Facility | | $83.18 | $83.18 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $35.48 / $35.48 / $35.48
| Professional | | $35.48 | $35.48 | $35.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $17.78 / $83.18
| Facility | | $13.18 | $17.78 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $15.85 / $32.36
| Professional | | $10.00 | $15.85 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $14.79 / $14.79
| Professional | | $13.18 | $14.79 | $14.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $17.78 / $51.29
| Facility | | $14.13 | $17.78 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $12.88 / $29.51
| Professional | | $10.00 | $12.88 | $29.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $17.78 / $21.38
| Facility | | $7.94 | $17.78 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $10.23 / $17.78
| Professional | | $7.41 | $10.23 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $9.12 / $17.78
| Professional | | $6.92 | $9.12 | $17.78 |